GRAND ITASCA FOUNDATION: Form 990, tax year 2024
View the entire original 990 at ProPublica ↗
- Organization
- GRAND ITASCA FOUNDATION (EIN 41-1560554)
- Tax period
- 2024-01-01 to 2024-12-31
- Filed
- 2025-11-07
- IRS object ID
- 202523119349303557
- Schema version
- 2024v5.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2025-11-07T13:57:50+00:00 | ReturnTs |
| Tax Period End | 2024-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2024-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411560554 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Grand Itasca Foundation | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GRAN | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1601 Golf Course Road | AddressLine1Txt |
| City | Grand Rapids | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55744 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Jean MacDonell | PersonNm |
| Person Title | President & CEO | PersonTitleTxt |
| Signature | 2025-11-07 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2024 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jean MacDonell | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1601 Golf Course Road | AddressLine1Txt |
| City | Grand Rapids | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55744 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $330,628 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | https://www.granditasca.org/Foundation | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1986 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | To build philanthropic partnerships to support the mission of Grand Itasca Clinic and Hospital. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $135,041 | PYContributionsGrantsAmt |
| CY Contributions Grants | $129,978 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,415 | PYInvestmentIncomeAmt |
| CY Investment Income | $30,652 | CYInvestmentIncomeAmt |
| PY Other Revenue | $92,697 | PYOtherRevenueAmt |
| CY Other Revenue | $111,990 | CYOtherRevenueAmt |
| PY Total Revenue | $229,153 | PYTotalRevenueAmt |
| CY Total Revenue | $272,620 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $186,196 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $336,935 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $17,250 | PYOtherExpensesAmt |
| CY Other Expenses | $10,272 | CYOtherExpensesAmt |
| PY Total Expenses | $203,446 | PYTotalExpensesAmt |
| CY Total Expenses | $347,207 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $25,707 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$74,587 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,750,233 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,433,236 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $262,166 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $272,436 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,488,067 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,160,800 | NetAssetsOrFundBalancesEOYAmt |
| Mission | To build philanthropic partnerships to support the mission of Grand Itasca Clinic and Hospital. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $336,935 | ExpenseAmt |
| Grant | $336,935 | GrantAmt |
| Desc | Grand Itasca Foundation enhances and helps to guarantee the delivery of contributions and provide financial support to Grand Itasca Clinic and Hospital. In 2024 Grand Itasca Foundation awarded $336,935 in total grant funding to organizations and individuals. This includes $290,224 to Grand Itasca Clinic and Hospital for patient focused projects, eight individual scholarship awards totaling $33,000 and care to share grants to 12 recipients for a total of $6,000, and $7,711 patient crisis grants where 198 recipients received financial help. | Desc |
| Total Program Service Expenses | $336,935 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | Yes (true) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (true) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (true) | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Policies Reference Chapters | false | PoliciesReferenceChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Todd Christensen | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2189991702 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1601 Golf Course Road | AddressLine1Txt |
| City | Grand Rapids | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55744 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| Elizabeth Miskovich | |||||||
| Co-Chair | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Rose Villenueve GNP | |||||||
| Co-Chair | 1.0 | 40.0 | Yes (X) | Yes (X) | $0 | $250,826 | $43,973 |
| Bryan Sergot | |||||||
| Director | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Crystal Burggraf | |||||||
| Director, new 1-2024 | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | |
| Dajana Condos DC | |||||||
| Director | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Katie Troumbly RN | |||||||
| Secretary | 1.0 | 40.0 | Yes (X) | $0 | $142,493 | $10,794 | |
| Kim Morse | |||||||
| Director, new 1-2024 | 1.0 | 40.0 | Yes (X) | $0 | $96,324 | $6,913 | |
| Mike Aultman | |||||||
| Director | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Mike Johnson | |||||||
| Director | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Nick Rothstein | |||||||
| Treasurer | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |
| Scott Gerling MD | |||||||
| Director | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Shane Skelly | |||||||
| Director | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Spencer Buchert DDS | |||||||
| Director | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Wendy Roy | |||||||
| Director | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Brianne Wagner | |||||||
| Foundation Director | 40.0 | 0.0 | Yes (X) | $0 | $145,047 | $41,339 | |
| Jean MacDonell | |||||||
| Ex-Officio | 1.0 | 40.0 | Yes (X) | $0 | $568,690 | $89,766 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,203,380 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $192,785 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $129,978 | AllOtherContributionsAmt |
| Total Contributions | $129,978 | TotalContributionsAmt |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $0 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $30,652 | TotalRevenueColumnAmt |
| Exclusion | $30,652 | ExclusionAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $169,998 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $58,008 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $111,990 | TotalRevenueColumnAmt |
| Exclusion | $111,990 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $272,620 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $142,642 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $290,224 | TotalAmt |
| Program Services | $290,224 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,711 | TotalAmt |
| Program Services | $46,711 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,640 | TotalAmt |
| Management And General | $4,640 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,327 | TotalAmt |
| Management And General | $3,327 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|
| Administrative Fees | $1,644 | $1,644 |
| Subscription fees | $635 | $635 |
| Filing Fee | $26 | $26 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $347,207 | TotalAmt |
| Program Services | $336,935 | ProgramServicesAmt |
| Management And General | $10,272 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,394,737 | BOYAmt |
| EOY | $874,275 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,863 | BOYAmt |
| EOY | $1,850 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $0 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $0 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $353,633 | BOYAmt |
| EOY | $557,111 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,750,233 | BOYAmt |
| EOY | $1,433,236 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $229 | BOYAmt |
| EOY | $229 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $10,244 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $261,937 | BOYAmt |
| EOY | $261,963 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $262,166 | BOYAmt |
| EOY | $272,436 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$329,431 | BOYAmt |
| EOY | -$576,458 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,817,498 | BOYAmt |
| EOY | $1,737,258 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,488,067 | BOYAmt |
| EOY | $1,160,800 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,750,233 | BOYAmt |
| EOY | $1,433,236 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$74,587 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$247,027 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$5,653 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type1 | Yes (X) | SupportingOrgType1Ind |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Grand Itasca Clinic and Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411865874 | EIN |
| Organization Type | 3 | OrganizationTypeCd |
| Governing Document Listed | Yes (true) | GoverningDocumentListedInd |
| Support | $289,224 | SupportAmt |
| Other Support | $0 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $289,224 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (true) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | false | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | false | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | false | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | false | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | false | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | false | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | false | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | false | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | false | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | false | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | false | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | false | ContributionControllerInd |
| Contribution Family | false | ContributionFamilyInd |
| Contribution35 Controlled | false | Contribution35ControlledInd |
Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Power Appoint Majority Dir Trst | Yes (true) | PowerAppointMajorityDirTrstInd |
| Operate Benefit Non Suprt Org | false | OperateBenefitNonSuprtOrgInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | false | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (true) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $646,026 | BeginningYearBalanceAmt |
| Contributions | $726,033 | ContributionsAmt |
| Investment Earnings Or Losses | $122,765 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $34,592 | GrantsOrScholarshipsAmt |
| Other Expenditures | $6 | OtherExpendituresAmt |
| Administrative Expenses | $13,820 | AdministrativeExpensesAmt |
| End Year Balance | $1,446,406 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $608,353 | BeginningYearBalanceAmt |
| Contributions | $500 | ContributionsAmt |
| Investment Earnings Or Losses | $65,602 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $22,331 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $6,098 | AdministrativeExpensesAmt |
| End Year Balance | $646,026 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $714,988 | BeginningYearBalanceAmt |
| Contributions | $2,040 | ContributionsAmt |
| Investment Earnings Or Losses | -$81,355 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $20,990 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $6,330 | AdministrativeExpensesAmt |
| End Year Balance | $608,353 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $655,056 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $86,136 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $19,326 | GrantsOrScholarshipsAmt |
| Other Expenditures | $50 | OtherExpendituresAmt |
| Administrative Expenses | $6,828 | AdministrativeExpensesAmt |
| End Year Balance | $714,988 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $527,409 | BeginningYearBalanceAmt |
| Contributions | $100,725 | ContributionsAmt |
| Investment Earnings Or Losses | $50,593 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $18,913 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $4,758 | AdministrativeExpensesAmt |
| End Year Balance | $655,056 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.0 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 1.0 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.0 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (true) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Assets limited as to use - restricted fund investment | $546,867 |
| Assets limited as to use - Run the Rapids | $10,244 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $557,111 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Federal Income Taxes | |
| Intercompany Payable | $261,963 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $261,963 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Other Revenue | $0 | OtherRevenueAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $0 | RevenueSubtotalAmt |
| Other Revenues Not Included | $0 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $0 | TotalRevenuePerForm990Amt |
| Other Expenses Included | $0 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $0 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $0 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $0 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule D, Part V, Line 3a(i) | The organizations endowment funds are held through Grand Rapids Area Community Foundation, an unrelated but nonprofit organization. |
| Schedule D, Part IV, Line 2b Explanation of escrow agreement | Grand Itasca Foundation acts as a fiscal agent for a local running event, Running the Rapids. |
| Schedule D, Part V, Line 4 Intended uses of endowment funds | THE ENDOWMENT FUNDS INCLUDE DONOR-RESTRICTED FUNDS. THE GRAND ITASCA FOUNDATION ENDOWMENT FUNDS ARE USED FOR GRAND ITASCA CLINIC AND HOSPITAL NEEDS, The Itasca Hospice Foundation Endowment funds are used to support patients and families in need of quality end of life services, and THE MR. AND MRS. ROBERT KELLY SCHOLARSHIP ENDOWMENT FUNDS ARE SOLELY FOR SCHOLARSHIPS. THE FOUNDATION INTENDS TO USE THEIR ENDOWMENT FUNDS IN THE MANNER FOR WHICH THEY WERE RESTRICTED. |
| Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote | Grand Itasca Foundation is part of Fairview Health Services. Fairview recognizes all tax positions, including those positions in a previously filed tax return or a position expected to be taken in a future tax filing that is reflected in measuring current or deferred income tax assets and liabilities, when it is more likely than not (likelihood of greater than 50%) that, based on technical merits, the position will be sustained upon examination. $8,300,000 and $6,800,000 uncertain tax positions recorded on the consolidated balance sheets as of December 31, 2024 and 2023, respectively. Fairview has made reasonable estimates of the provision for income taxes and on existing deferred tax balances based on accounting guidance included in ASC 740, Income Taxes. Fairview does not expect that there will be a significant change in the total amount of unrecognized tax benefits within the next 12 months. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Caring For Kids Golf Tournament | Event1Nm |
| Gross Receipts Event1 | $169,998 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $169,998 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $1,100 | CashPrizesEvent1Amt |
| Non Cash Prizes Event1 | $2,604 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $22,659 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $18,059 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $1,000 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $12,586 | OtherDirectExpensesEvent1Amt |
| Gross Revenue Event2 | $0 | GrossRevenueEvent2Amt |
| Gross Revenue Other Events | $0 | GrossRevenueOtherEventsAmt |
| Gross Receipts Total | $169,998 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $169,998 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $1,100 | CashPrizesTotalEventsAmt |
| Non Cash Prizes Total Events | $2,604 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $22,659 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $18,059 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $1,000 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $12,586 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $58,008 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $111,990 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Grand Itasca Clinic and Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1601 Golf Course Road | AddressLine1Txt |
| City | Grand Rapids | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55744 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 411865874 | RecipientEIN |
| IRC Section | 501( c)(3) | IRCSectionDesc |
| Cash Grant | $289,224 | CashGrantAmt |
| Purpose Of Grant | To support the program services of Grand Itasca Clinic and Hospital | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (3 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt |
|---|---|---|
| Scholarships | 8 | $33,000 |
| Care to Share Grants | 12 | $6,000 |
| Patient Crisis Grants | 198 | $7,711 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds | FormAndLineReferenceDesc |
| Explanation | All grant requests are approved or denied by the Foundation board prior to approval and/or payment and must be in line with the Foundation's mission of helping to support the internal needs of Grand Itasca Clinic & Hospital, promoting a healthy community, and raising awareness of the impact and value of Grand Itasca Clinic & Hospital. Scholarship funds are sent directly to the school on behalf of the recipient. If a student has any changes (transfers, etc.) we receive funds back for unused dollars, but the Foundation does not follow-up with students/recipients specifically about their scholarship funds. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Rose Villenueve GNP | ||||||||||||||
| Co-Chair | $0 | $191,209 | $0 | $54,094 | $0 | $5,523 | $0 | $13,656 | $0 | $30,317 | $0 | $294,799 | $0 | $0 |
| Katie Troumbly RN | ||||||||||||||
| Secretary | $0 | $134,201 | $0 | $7,588 | $0 | $704 | $0 | $8,495 | $0 | $2,299 | $0 | $153,287 | $0 | $0 |
| Jean MacDonell | ||||||||||||||
| Ex-Officio | $0 | $411,164 | $0 | $126,585 | $0 | $30,941 | $0 | $88,249 | $0 | $1,517 | $0 | $658,456 | $0 | $29,940 |
| Brianne Wagner | ||||||||||||||
| Foundation Director | $0 | $130,497 | $0 | $13,838 | $0 | $712 | $0 | $9,213 | $0 | $32,126 | $0 | $186,386 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan | THE FOLLOWING INDIVIDUALS PARTICIPATED IN A NONQUALIFIED RETIREMENT PLAN: JEAN MACDONELL DUE TO A VESTING EVENT, THE FOLLOWING INDIVIDUALS HAD INCOME IN PART VII AND SCHEDULE J RELATED TO A NONQUALIFIED RETIREMENT PLAN: JEAN MACDONELL $29,940 |
| Schedule J, Part I, Line 7 Non-fixed payments | FAIRVIEW HEALTH SERVICES PROVIDES LUMP SUM FINANCIAL AWARDS BASED ON SYSTEM-WIDE, BUSINESS UNIT AND/OR DEPARTMENTS FINANCIAL AND QUALITY MEASURES. ANNUAL GOALS, SPECIFICALLY TIED TO PRODUCTIVITY AND QUALITY INDICATORS, ARE SET FOR THE YEAR AND AN INCENTIVE PAID OUT ANNUALLY IF KEY GOALS AND MEASURES ARE ACHIEVED. THE NON-QUALIFIED PLAN (THE PLAN) IS ONLY OPEN TO A SELECT GROUP OF HIGHLY COMPENSATED EMPLOYEES. THE PLAN CONTRIBUTES THE DIFFERENCE OF WHAT 403(B) EMPLOYER CONTRIBUTIONS WERE MISSED FOR PARTICIPANTS WHO EARN MORE THAN THE IRS LIMIT ON ELIGIBLE COMPENSATION FOR QUALITIED RETIREMENT PLANS. PARTICIPANTS MAY NOT ELECT TO DEFER COMPENSATION. CONTRIBUTIONS WILL BE MADE IN THE FORM OF A CREDIT TO THE PARTICIPANT'S ACCOUNT, WITHIN 60 DAYS AFTER A PARTICIPANT BECOMES VESTED IN A CONTRIBUTION. THE PLAN SHALL PAY TO THE PARTICIPANT AN AMOUNT EQUAL TO THE AMOUNT THE PARTICIPANT IS REQUIRED TO PAY FEDERAL, STATE, LOCAL AND FOREIGN INCOME TAXES AND EMPLOYMENT TAXES DUE TO THE VESTING. THE REMAINING AMOUNT IN THE PARTICIPANT'S ACCOUNT SHALL NOT BE PAID UNTIL THE SEPARATION FROM SERVICES PAYMENT DATE. A PARTICIPANT'S ACCOUNT SHALL BE DISTRIBUTED IN CASH. THE PLAN COMPLIES WITH SECTION 457(F) OF THE IRS CODE. |
| Schedule J, Part I, Line 3 Related Org to establish compensation | THE ORGANIZATION IS PART OF THE FAIRVIEW HEALTH SERVICES SYSTEM AND FAIRVIEW HEALTH SERVICES HUMAN RESOURCES USES COMPARABLES TO ESTABLISH COMPENSATION FOR THE CEO/EXECUTIVE DIRECTOR ACCORDING TO MARKET STANDARDS. |
| Schedule J, Part I, Line 4b Other Additional Information | The non-qualified plan (the plan) is only open to a select group of highly compensated employees. The plan contributes the difference of what 403(b) employer contributions were missed for participants who earn more than the IRS limit on eligible compensation for qualitied retirement plans. Participants may not elect to defer compensation. Contributions will be made in the form of a credit to the participant's account, within 60 days after a participant becomes vested in a contribution. The plan shall pay to the participant an amount equal to the amount the participant is required to pay federal, state, local and foreign income taxes and employment taxes due to the vesting. The remaining amount in the participant's account shall not be paid until the separation from services payment date. A participant's account shall be distributed in cash. The plan complies with Section 457(f) of the IRS code. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part V, Line 1a Part V, Line 1a | All cash disbursements are centralized through a related organization, Fairview Health Services a 501(c)3 non-profit tax-exempt organization. Therefore, the related organization, Fairview Health Services, makes the payment and files the related Form 1099's and Form 1096 instead of this organization. |
| Form 990, Part V, Line 2a | Grand Itasca Foundation leases employees from a related organization, Grand Itasca Clinic and Hospital, a 501(c)(3) tax-exempt, non-profit organization. Therefore, Grand Itasca Clinic and Hospital files the appropriate W-3 and related W-2 tax forms for these individuals instead of Grand Itasca Foundation. The leased employee compensation on the Grand Itasca Foundation Form 990 Part VII and Schedule J is reported as compensation paid by related organization, Grand Itasca Clinic and Hospital. |
| Form 990, Part V, Line 15 Section 4960 Tax | Fairview Health Services, a related 501(c)3 tax-exempt organization, files and remits all related Section 4960 excise tax on Form 4720 for the system. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | Grand Itasca Clinic & Hospital, a Minnesota nonprofit corporation, is the sole member of Grand Itasca Foundation. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | Grand Itasca Clinic & Hospital, as the only voting member of Grand Itasca Foundation, has the authority to elect and remove the directors of Grand Itasca Foundation with or without cause, at any time. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | Various powers, as stated in Section 4.4 of Grand Itasca Foundation's bylaws, are reserved for Grand Itasca Clinic & Hospital, the one voting member of Grand Itasca Foundation |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | Form 990 is reviewed by the Board of Directors and the Foundation director prior to filing with the IRS. |
| Form 990, Part VI, Line 12c Conflict of interest policy | Conflict of Interest policies are reviewed annually. Conflict of Interest forms are signed annually by all board members. |
| Form 990, Part VI, Line 19 Required documents available to the public | Financial statements, conflict of interest policy and governing documents are available upon request for the same period of disclosure as set forth in Section 6104(D). |
| Form 990, Part VII, Section B, Line 1 Additional Information | Form 1099's were filed by a related organization Fairview Health Services, a 501(c)(3) non-profit, tax-exempt organizations. Fairview Health Services reports the five highest compensated independent contractors for the system. |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | Net Asset Adjustment - -5653; Total - -5653; |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Grand Itasca Clinic and Hospital | ||||||||||
| 1601 Golf Course Road | Grand Rapids | MN | 55744 | 411865874 | Hospital | MN | 501(c)(3) | 3 | Fairview Health Services | false |
| Fairview Health Services | ||||||||||
| 2450 Riverside Avenue | Minneapolis | MN | 55454 | 410991680 | Hospital | MN | 501(c)(3) | 3 | NA | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CDI Grand Rapids LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1601 Golf Course Road | AddressLine1Txt |
| City | Grand Rapids | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55744 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 453783014 | EIN |
| Primary Activities | MRI-DTI | PrimaryActivitiesTxt |
| Legal Domicile State | MN | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Grand Itasca Clinic and Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | N/A | PredominantIncomeTypeTxt |
| Disproportionate Allocations | false | DisproportionateAllocationsInd |
| General Or Managing Partner | false | GeneralOrManagingPartnerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |